Massive body-brain disconnection consequent to spinal cord injuries drives profound changes in higher-order cognitive and emotional functions: A PRISMA scoping review

Neurosci Biobehav Rev. 2023 Nov:154:105395. doi: 10.1016/j.neubiorev.2023.105395. Epub 2023 Sep 20.


Spinal cord injury (SCI) leads to a massive disconnection between the brain and the body parts below the lesion level representing a unique opportunity to explore how the body influences a person's mental life. We performed a systematic scoping review of 59 studies on higher-order cognitive and emotional changes after SCI. The results suggest that fluid abilities (e.g. attention, executive functions) and emotional regulation (e.g. emotional reactivity and discrimination) are impaired in people with SCI, with progressive deterioration over time. Although not systematically explored, the factors that are directly (e.g. the severity and level of the lesion) and indirectly associated (e.g. blood pressure, sleeping disorders, medication) with the damage may play a role in these deficits. The inconsistency which was found in the results may derive from the various methods used and the heterogeneity of samples (i.e. the lesion completeness, the time interval since lesion onset). Future studies which are specifically controlled for methods, clinical and socio-cultural dimensions are needed to better understand the role of the body in cognition.

Keywords: Cognitive functions; Deafferentation and deafferentation; Embodied cognition theories; Emotions; Interoception; Locked-in syndrome; Post-lesional plasticity; Spinal cord injury.

Publication types

  • Systematic Review
  • Review

MeSH terms

  • Brain
  • Cognition / physiology
  • Emotions* / physiology
  • Executive Function
  • Humans
  • Spinal Cord Injuries* / complications